by Guy Taylor
An epidemic of Oxycodone abuse has struck America in the last decade. The number of emergency room visits stemming from non-medical abuse of the narcotic prescription painkiller drug rose by 256 percent between 2004 and 2009, according to the U.S. government’s Drug Abuse Warning Network.
In March 2010, Washington state Attorney General Rob McKenna said his state was “losing more people to prescription drug overdoses in a typical year than to traffic accidents.” In Florida, the Medical Examiners commission found more than 1,500 people died of Oxycodone overdose in 2010, a four-fold increase over the 350 who died in 2005. The supply of Oxycodone, says Jim Hall, director of the Center for the Study and Prevention of Substance Abuse at Nova Southeastern University, went “far beyond the legitimate medical need of the state.”The epidemic is not likely to abate soon. The explosion of pain management clinics in Florida, dubbed “pill mills,” prompted the state Legislature last year to close a loophole that had allowed physicians to fill Oxy prescriptions on the spot. Authorities say a half-billion doses of Oxycodone and its generic equivalents were distributed in the state during 2009 alone. An unknown number wound up in the hands of “patients” who had come from out of state to have prescriptions filled by multiple pill mills, before driving home to resell the pills on the black market.
The scope of damage wrought by Oxycodone’s oversupply in Florida is felt nationwide. In Maine, an official from the state’s Office of Substance Abuse sent me an internal spreadsheet showing that more than 4 million prescription painkiller pills had been legally prescribed by state physicians in 2010, five times the amount legally dispensed in 2006. Officials in Ohio went one step further, identifying the per capita amount of opioids being prescribed county-by-county. Jackson County, in the southern part of the state, won the alarming distinction of having more than 130 doses for every resident in 2010. The number of pills prescribed in Ohio has risen by 900 percent since 1997, a powerful indicator that the market for pills has become oversaturated.
“There’s just no way that there’s been a 900 percent increase in pain,” says Stacey Frohnapfel-Hasson, chief of communications for Ohio’s Department of Alcohol and Drug Addiction Services.
A 1,200 percent increase
One of the most disturbing things about the prescription pain pill abuse epidemic is that it could have been avoided, or at least mitigated, if the DEA had fulfilled the responsibilities vested in it under federal law.
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It’s well known that narcotic prescription drugs sold in the United States must first be approved by U.S. Food and Drug Administration before they can be legally mass produced and marketed. Less known is the fact that the DEA – and specifically, the Office of Diversion Control – then has the power and responsibility to decide how much of a particular drug can be legally manufactured and sent to market each year.The pharmaceutical companies that make Oxycodone and its two dozen generic equivalents — such as Endocodone, Oxyfast and Percocet — are required by law to present an annual application to the Office of Diversion Control seeking approval for a quota of the drug’s annual production. Should a company desire to manufacture more than the previous year, it must request an increase — and the DEA must approve.
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In 1997, a year after prescription drugmaker Purdue Pharma first brought Oxycontin (the first branded version of Oxycodone) to market, the total production quota approved by the Office of Diversion Control was 8.3 tons. By 2011, it had risen to 105 tons, an officially sanctioned 1,200 percent increase over the same period that saw Oxycodone emerge as what Haislip calls “the Cadillac of America’s prescription drug abuse crisis.”That the DEA allowed for the increases in the face of widespread illegal and non-medical use shows a ”serious lack of accountability and oversight,” says Haislip.
“The DEA is the lone federal agency with the power to decide how much of the drug gets made and put out there; it alone has had all the responsibility to do something about this problem,” he said. “The way I did it for 17 years, which was basically the way it had always been done even before the DEA was the DEA, is that when a significant diversion problem occurred, the quota increase requests would come under greater scrutiny.”
“With Oxy,” said Haislip, “there has been a significant diversion problem since the late 1990s, so the requests should have come under greater scrutiny.” That apparently didn’t happen, he says.
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